Review of the U.S. Navy Environmental Health Center's Health-Hazard Assessment Process (2000)

THIS SECTION describes the history of the Navy Environmental Health Center (NEHC) and its relationship with the Navy Bureau of Medicine and Surgery (BUMED), and other Navy organizations. NEHC originated in 1964 at the Navy Bureau of Weapons, which recognized the need for an occupational health program that would encompass allfleet readiness and training ordnance field activities. The Bureau of Weapons directed the Naval Ammunition Depot (NAD), Crane, Indiana, to address this need by broadening the command's occupational health function. This expanded mission included providing assistance to all naval ammunition depots and naval stations in coordinating their occupational health programs and resulted in the completion of the first industrial hygiene survey.

From 1965 to 1967, the NAD program steadily expanded in response to new mission requirements for personnel education and survey procedures. In May 1967, the Bureau of Weapons formalized this function by establishing the Naval Ordnance Systems Command Environmental Health Center under the auspices of the NAD Crane Medical Department.

On July 1, 1970, the Center became a Headquarters Detachment of the Naval Ordnance Systems Command, which subsequently became

the Naval Ordnance Environmental Health Center. In 1971, NEHC was brought under the control of BUMED and was renamed the Navy Industrial Environmental Health Center.

In July 1974, the Center became the Navy Environmental Health Center (NEHC), an Echelon 3 shore activity under the command and support of the Chief, Bureau of Medicine and Surgery. In the fall of 1978, the command was relocated to Norfolk, Virginia. This relocation was undertaken in response to an increase in requests for fleet support and further expansion of NEHC's occupational health mission. This expanded role included responsibility for the Navy Occupational Safety and Health Inspection Program, analytical laboratory services, radiation health, hazardous materials identification, asbestos hazard control, preventive medicine, epidemiology, and hearing conservation.

NEHC's mission was expanded again in 1981 to include coordination and provision of centralized support and occupational health, environmental health, and preventive medicine services to medical activities ashore and afloat. The Navy Disease Vector Ecology and Control Centers and Navy Environmental and Preventive Medicine Units were placed under NEHC as Echelon 4 commands at that time.

NEHC reports directly to BUMED, which in turn reports to the Chief of Naval Operations (CNO). BUMED is a large organization within the Navy with medical facilities on ships and ashore around the world. Because NEHC plays a central role in preparing health-hazard assessments, it is the primary source of information for occupational and environmental disease prevention programs managed by BUMED. The Chief, Bureau of Medicine and Surgery, is responsible for a number of activities that might require support from the NEHC. These activities include

• determining, validating, and establishing health-related criteria and standards that are not available through federal, state, or local agencies;

• providing assistance to activities, offices, and commands concerning the health aspects of pollution sources or pollution-control equipment, including development of medical monitoring programs;

• providing industrial hygiene and medical expertise for activities during spill events and other environmental emergencies via Navy hospitals and clinics, Navy Environmental Preventive Medicine Units, and Navy Disease Vector Ecology Control Centers;

• coordinating with the Agency for Toxic Substances and Disease Registry (ATSDR) for the timely completion of public health assessments for National Priorities List sites, toxicological profiles on any specific contaminants, health education, health consultations, and other activities provided in the DOD/ATSDR Annual Plan of Work.

In support of these activities, BUMED has issued directives that are in accord with current accepted standards of toxicological sciences and clinical medicine. Also, BUMED

• provides support in the areas of ATSDR public health assessments, review of toxicological profiles, environmental-risk communication workshops, review of site health and safety plans, and review of ecological risk assessments;

• coordinates with ATSDR concerning ATSDR's legally mandated health-related activities, including public health assessments, public health consultations, health surveys and investigations, toxicology databases, emergency response, Naval Facilities Engineering Command and health education;

• assists Naval Facilities Engineering Command (NAVFACENGCOM) and installations to prepare for public meetings and respond to community concerns regarding program health and safety.

BUMED also issues directives for shipboard medical personnel that provide guidance for determining, validating, and establishing health criteria and standards for chemical and physical exposures.

There is direct communication with, and support from, the Engineering Field Divisions/Engineering Field Activities (EFD/EFA) providing NEHC with pertinent risk- management options. Both EFD/EFA work with the Naval Facility Engineering Service Center (NFESC) and both report to the NAVFACENGCOM. BUMED and NAVFACENGCOM also coordinate their activities. Thus, there is an organizational framework within the Navy to detect and identify potential human and environmental health hazards, determine risk to health, and implement appropriate controls to protect the health of personnel. CNO has stated that, “The Navy chain of command must provide leadership and a personal commitment to ensure that all Navy personnel develop and exhibit an environmental protection ethic.”

However, BUMED is the final arbiter regarding the prevention, diagnosis, and treatment of exposures to toxic hazards.